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STUDY OF THE FUNCTIONAL STATE OF SPINAL CORD PATHWAYS
IN POSTHERPETIC TRIGEMINAL NEURALGIA
Mukhamadieva Ferangiz Shukhratovna
Bukhara State Medical Institute
TEZIS
https://orcid.org/0009-0005-9722-4215
https://doi.org/10.5281/zenodo.15139190
The purpose of the study:
The functional state of the spinal cord
pathways, including the efferent pathways (EPSM) — pyramidal tract, and
afferent pathways (APSM) was studied in patients with postherpetic trigeminal
neuralgia (PNTN). The study involved 7 women and 6 men with herpes zoster
syndrome, which developed after ophthalmic herpes zoster. All patients had
predominant clinical manifestations in the innervation zone of the I branch of
the trigeminal nerve, accompanied by acute neuropathic pain. The examination
was performed 4-7 weeks after the disappearance of the rash. Pain in the area of
the I branch of the trigeminal nerve persisted in all patients with a unilateral
character (14 on the right, 9 on the left). Earlier, the results of a study of the
functional state of the trigeminal-facial complex and afferent pathways of the
brain stem of this group of patients were published. To assess the functional
state of EPSM, transcranial, cervical and lumbar magnetic stimulation (MS) were
used according to the classical method. Measurement of the latent periods of
motor responses in MS made it possible to determine the time of the central
motor conduction (CMP) from the cerebral cortex to the roots of the cervical
(CVI—CVII) and lumbar (LIV—SI) spine. The functional state of the APSM was
studied using spinal cord MS in the cervical and lumbar regions, recording the
motor responses of the circular muscles of the eye, and measuring the rate of
propagation of arousal (RVR) along the APSM.
The results showed that 8 (34.8%) patients with PNT had violations of
EPSM excitation. In 6 patients, this was manifested in an increase in the ICMP-1
index (motor cortex—cervical spine) to 11.4± 0.4 ms, and in 4 patients — at the
level of "motor cortex—lumbar spine", where ICMP-2 increased to 20.7±0.6 ms.
In two cases, changes were detected throughout the studied EPSM area.
Disorders of the functional state of APSM were detected in 15 (65.2%) patients,
which manifested itself in a decrease in the CPV of APSM to 42-64 m/s, including
bilateral changes in 7 patients. 6 patients showed signs of disorders in both
EPSM and APSM.
CURRENT APPROACHES AND NEW RESEARCH IN
MODERN SCIENCES
International scientific-online conference
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Conclusions:
Studies have shown that patients with PNT have disorders of
arousal in both EPSM and APSM. These changes are more likely to affect sensory
or afferent pathways. It is assumed that changes in the functional state of
various parts of the pain sensitivity system may be associated with the
formation of a pathologically enhanced excitation generator at the level of the
trigeminal nerve nuclei, which then affects neurons at different levels. These
results confirm the previously proposed hypothesis. Thus, the results of the
study indicate changes in the functional state of both the efferent and afferent
pathways of the central nervous system, and can be used for dynamic
monitoring of patients with PNT to assess the extent of damage to the nervous
system.
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